Heart disease strikes South Asians earlier and more severely. Vascular repairs offer insight into why: study

A new Canadian study suggests that the timeline for heart disease is accelerated in people of South Asian descent, and part of the answer may lie in faulty repairs of blood vessel damage.

Cardiovascular disease affects the heart and blood vessels and can lead to the need for bypass surgery and other treatments.

Researchers previously estimated that people from the Indian subcontinent — including India, Pakistan, Bangladesh, Sri Lanka and more than 50 other South Asian origins, representing a quarter of the world’s population — develop cardiovascular disease about five to 10 years earlier than white European patients. Their death rates are higher after a heart attack.

In Monday’s issue of Journal of the American College of CardiologySouth Asian patients with heart disease or diabetes have fewer regenerative and reparative blood vessel cells than white patients, researchers from Canada, the United States and Ireland reported.

The findings “suggest that there is something unique about South Asian individuals that puts them at risk in part through their inability to mount an appropriate compensatory response,” said Dr. Subodh Verma, co-author of the study and a cardiothoracic surgeon at St. Michael’s Hospital. in Toronto and a professor at the University of Toronto.

The study compared 60 adults who self-identified as South Asian with 60 white Europeans in primary care or outpatient cardiology clinics in the Toronto area, who had either documented cardiovascular disease or diabetes, with at least one risk factor for heart disease. .

A man wearing a lab coat over scrubs is on the left and another man is wearing a black jacket over a blue striped shirt on the left.
Dr. Subodh Verma, left, is a cardiothoracic surgeon at St. Michael’s Hospital and a professor at the University of Toronto. David Hess is an affiliated scientist at St. Michael’s Hospital and a professor in the Department of Physiology and Pharmacology at Western University in London, Ontario. (Unity Health Toronto)

Significant decrease in stem cells

David Hess, an affiliated scientist at St. Michael’s Hospital and a professor in the department of physiology and pharmacology at Western University in London, Ontario, has found a way to screen blood cells from patient samples and use different markers to pick out the main stem. cells.

“There are three different types we look at, and the top two types of stem cells are significantly reduced in South Asian people compared to white European people,” Hess said. “This would indicate or imply that they have a reduced ability to repair and regenerate their blood vessels in response to diabetes.”

When Verma, Hess and co-authors took risk factors such as weight, age, gender and obesity into account in their analysis, they still found a lack of repair.

Dr. Jaydeep Patel, a Canadian preventive cardiologist at Johns Hopkins Hospital in Baltimore who was not involved in the latest study, was part of Expert Committee in 2023 On the management of atherosclerotic cardiovascular disease in a South Asian population in the United States

“Taken together, the results of this study remain novel,” Patel said in an email, praising the authors for their efforts.

“The clock of cardiovascular disease risks is accelerating.”

Other than the small sample size, a major limitation of the study is that it did not include healthy participants, so it is not known whether the presence of atherosclerotic cardiovascular disease or other risk factors affects stem cells differently, Patel said.

More research is needed to prove that low levels of stem cells cause weak blood vessels and an increased risk of heart complications.

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For now, Verma said, it’s important for everyone to be aware of their risk factors, including family history or risk factors they acquire — such as smoking, diabetes, low physical activity, high stress, high blood pressure, or high blood pressure.

“The clock of cardiovascular disease risk is ticking in South Asia,” he said.

Patel added risk factors specific to women, such as polycystic ovary syndrome, gestational hypertension, and gestational diabetes, to the list.

Both doctors suggested that those most at risk could be more vigilant.

The study authors next hope to address whether the biological difference they discovered could be used to identify people at risk early and investigate whether there are specific treatments that could be given earlier.

The study was funded by the Heart and Stroke Foundation of Canada and the Canadian Institutes of Health Research.

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